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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002475
Report Date: 07/23/2019
Date Signed: 07/23/2019 03:16:39 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:COASTSIDE CHILDREN'S PROGRAMS - MONTARAFACILITY NUMBER:
414002475
ADMINISTRATOR:MARY BRISEBOISFACILITY TYPE:
850
ADDRESS:1100 LE CONTE AVENUETELEPHONE:
(650) 726-7413
CITY:MONTARASTATE: CAZIP CODE:
94037
CAPACITY:40CENSUS: 17DATE:
07/23/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Mary BriseboisTIME COMPLETED:
02:00 PM
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2, Licensing Program Analyst, LPA Yee conducted an annual random inspection today. There are 17 napping children and four staff members present today. The purpose of the inspection was explained. Days and Hours of operation are Monday - Friday, 7:00 AM-6:00 PM. This is a combination center which includes preschool and school-aged programs. Preschool program operates in building #1. The facility meets the teacher/child ratio today. Children toys, equipment, furniture are age-appropriate and in good repair. The facility is ventilated properly. Staff bathrooms are available in each building. Isolation for a sick child is available in the site director office then call parents for pick up. The outdoor play area is securely fenced. There is a large sandbox in the outdoor play area. Mary said staff checks the sandbox every morning to ensure no foreign materials inside the sandbox before using it. Children have their own cubbies. Bedding, mats, napping equipment are stored separately. The facility provides meals. All staff members have current CPR and First Aid which expires 3/2020. Required immunization for staff is on file. No apparent health and safety hazards were observed today. The facility personnel summary report was reviewed with the site director and she said it's current. LPA discussed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. Child Abuse Mandated Reporter Training, AB1207. https://www.mandatedreporterca.com/ All staff members have AB1207 certificate on file. Emergency drills were conducted monthly. A log sheet was available.

Website: www.ccld.ca.gov. Title 22, Div 12, Chp 1

Notice of site visit shall remain posted for 30 days from today.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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